The quest for "diagnostically lossless" medical image compression: A comparative study of objective quality metrics for compressed medical images

Our study, involving a collaboration with radiologists (DK, NSK) as well as a leading international developer of medical imaging software (AGFA), is primarily concerned with improved methods of assessing the diagnostic quality of compressed medical images and the investigation of compression artifacts resulting from JPEG and JPEG2000. In this work, we compare the performances of the Structural Similarity quality measure (SSIM), MSE/PSNR, compression ratio CR and JPEG quality factor Q, based on experimental data collected in two experiments involving radiologists. An ROC and Kolmogorov-Smirnov analysis indicates that compression ratio is not always a good indicator of visual quality. Moreover, SSIM demonstrates the best performance, i.e., it provides the closest match to the radiologists' assessments. We also show that a weighted Youden index(1) and curve fitting method can provide SSIM and MSE thresholds for acceptable compression ratios.